Rachel Vowels Delk
Nicholasville,KY
Summary
Professional in health plan and provider relations with solid background in building and maintaining network partnerships. Strong focus on team collaboration and delivering results, adaptable to changing needs. My ability to multitask and provide exceptional provider and network support has solidified my reputation for reliability and dedication, driving improvements in health plan relationships and provider satisfaction. Committed to fostering positive relationships and enhancing operational efficiency.
Overview
19
19
years of professional experience
Work History
Senior Practice Performance Advisor
Evolent Health
11.2019 - Current
- Developed positive relationships with practice and health plan partners to ensure consistent retention and loyalty.
- Effectively communicate account performance to the practice and internal stakeholders
- Monitored key performance goals (e.g., portal utilization, expedited requests, AUC scores etc.) to successfully increase practice performance metrics.
- Enhanced provider satisfaction and trust by addressing and resolving inquiries in a timely manner.
- Scheduled and facilitated meetings among team members to effectively track outreach efforts for assigned market expansions.
- Collaborated with internal departments to resolve complex provider issues, maintaining positive relationships and open communication of resolution tracking and completion.
- Participated in cross-functional teams tasked with improving overall performance metrics within Performance Suite for Cardiology.
- Assisted providers in navigating through new health plan implementation and portal onboarding to ensure clear understanding of platform functions and increased practice success.
Provider Relations Specialist II
Passport Health Plan
05.2017 - 11.2019
- Manages physician and facility networks by developing and maintaining relationships to drive business results in a specific
geographic region - Proactively identifies and works to solve complex problems impacting operations management and business direction
- Protected company reputation and built loyal client base by working to resolve problems and improve customer satisfaction
- Achieve company targets through implementation of Network Improvement plans, working provider workshops, seminars, and
meetings as appropriate - Participates in physician workgroup and donation and sponsorship committees, including attending industry specific events and
plan sponsored events - Works collaboratively with external vendors, providers, direct leadership and co-workers of all levels within the company
- Works to resolve conflicts and negotiate agreements between parties in order to reach win-win solutions to disagreements and
clarify misunderstandings - Maintains regulatory knowledge of Centers for Medicare & Medicaid Services (CMS) billing and coding guidelines to promote
compliance and proper reimbursement
Provider Relations/Network Development
Beacon Health Options
07.2015 - 05.2017
- Processing, auditing, data entry and claims reprocessing for Single Case Agreements
- Communicating with providers on a daily basis to ensure agreement completion
- Identifying and resolving provider issues by researching causes and working with clinical, operational, and data teams in
correlation with health plans - Building collaborative relationships with client and health plan counterparts
- Liaised between employees and senior leadership to address inquiries, complete contract processing and foster problem
resolution. Insured that all data components were present and accurate to insure correct reimbursement - Negotiated collective bargaining agreements on behalf of company
- Protected company reputation and built loyal client base by working to resolve problems and improve customer satisfaction
Patient Access Service Representative
Baptist Health Formally Hardin Memorial Hospital
08.2005 - 07.2015
- Work cooperatively with Insurance Benefit Coordinators and Management to identify opportunity for improvement in
communication with providers and patients - Prepared and administered training on registration/scheduling for various departments including outpatient and inpatient
procedures across facilities - Utilized highly effective scheduling and interpersonal skills to cultivate and build professional relationships with the company's management team
- Collaborated with healthcare professionals to optimize patient flow and minimize delays in care delivery.
- Managed high call volumes with professionalism and patience, prioritizing customer service while multitasking effectively.
- Resolved conflicts in scheduling or resource allocation quickly and professionally, minimizing disruptions to daily operations.
- Maintained accurate records of patient demographics, insurance information, and medical history in electronic health systems.
Education
Elizabethtown Community Technical College
Elizabethtown, KYSkills
- Problem-solving
- Educational presentations
- Provider support
- Multitasking
- Reliability and dedication
- Strategic business relationships
- Adaptability
- Professional and courteous
- Health plan operations
- Team collaboration
Timeline
Senior Practice Performance Advisor
Evolent Health
11.2019 - Current
Provider Relations Specialist II
Passport Health Plan
05.2017 - 11.2019
Provider Relations/Network Development
Beacon Health Options
07.2015 - 05.2017
Patient Access Service Representative
Baptist Health Formally Hardin Memorial Hospital
08.2005 - 07.2015
Elizabethtown Community Technical College
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